Some advice/guidance needed please.

[MyNameIsTerry]

Hi Golden,

I'm really sorry to hear you have felt the need to be admitted. I know you were very worried about this and what it represented but it could also allow you some additional support at this extremely difficult time so try not to see it as a failure. I bet you will, it's normal to feel that way about anything we feel is a lapse or not even a progression but try not to kick yourself too much.

They have let you down again with the CBT. Was that the catalyst to the admission or did it come on top of it? I don't think this is good enough either way and if you are able to use that proactive strength that you have demonstrated throughout your thread, can you push them over it? I got hit with that problem myself and I pursued my GP on it, stated I would go private, he referred me into the service above (it was only the IAPT provider I was having a problem with) and the nurse that called me must have given them a bit of a kick because the 3 month wait turned into a 7 day wait. She was told by the service manager that there was no chance but she went away and this was magicked up out of nowhere so she must have pressed my case with someone. Basically I was pushed into Level 2, had that for a couple of months and the told to wait 3 months for Level 3 - but I was told all the time only Level 3 would help me. I argued that the only reason I couldn't access what I needed, and the only thing they said I needed, was because they were forcing bureaucracy onto me and the failing in the management of their service were not my problem. I was prepared to fill the gap in with private work if needed as I didn't want to take somebody else's place by complaining and I made that very clear to them, yet they still plucked out a free therapist for 12 weeks for me. I wonder whether you can get them to pull their finger out? Can you complain the delays will only make you feel worse?

What you mentioned about your intrusive thoughts about the nurse helping you are something I can relate to. I think when you have intrusive thoughts about the people you love more than anything, they can easily settle on someone not on that level of importance in your life. I think the reason they do it is the same - choosing someone that you have a positive connection to in order to create the greatest level of response. Normally this may not be enough for it with someone who helps you in a shop but in your situation you found someone who you really felt happy to be around because they were helping you at such a desperate time and BANG, your subconscious finds itself another person to use.

You are not alone in that, I had it. If you told that nurse about those thoughts, I bet you they would shrug it off like it was nothing. I've seen someone else on here actually mention it to be told it was nothing to the mental health professional who said they were used to it. That's the thing, to us it's the end of the world but to them it's just part of the job. You should see the posts on the HA board about people worrying over talking to their GP or about an embarrassing condition yet to a GP that's as much an event in their day as would be for someone to do some photocopying in the office. They obviously see that it is a major issue to the sufferer, so not the same as that photocopying, but in their mind that is probably all the attachment it gets from a fear perspective because they understand it's normal in these conditions. Do you see what I mean? So, you really mustn't worry about this and tell them if you feel you need to or if it will help you.

The thing is, these people work in place where they have to be able to work with patients with very challenging conditions. Someone on here had a relative who was sectioned due to psychosis and he worried what if he assaulted the doctor again and the doctor just shrugged it off and reassured the family they are used to it, it's part of the job. It's not like NHS doctors/nurses outside of these areas, it's an essential hazard of the job, just as it is to a police officer.

So, when you think about you, someone worried & anxious telling them your thoughts when compared to someone in psychosis doing a lot more than just telling them and in a dangerous state of mind, how do you think she would respond to you? Would she think "this person sitting here thanking me has just said she had a thought to do X to me" and panic? Or would she see that you are not exhibiting any behaviour that is threatening, that you are positive towards her, and that you have just described an intrusive thought to her - and her training & experience tells her just how rare it is for someone with OCD to act those out.

Do you think you became dependent on the Diazepam? How long were you on it and how long did you use it? How did you taper off? Doctor's can be a bit poor with taper plans sometimes and perhaps this could be relevant to the fact you feel worse than you could do? There are people on here that have been dependent on various Benzo's and they are a great source of information on tapers and how you will feel through them. I can tell you how to get their attention on here by where you post and give you some names of helpful members if so.

There are various CBT packages out there. The NHS offer a couple such as FearFighter, Beating The Blues, etc. Be careful with these as they can be chargeable without NHS approval for the cost first. These may have been the ones they said you couldn't access right now as they need to have a support worker in place although I'm not sure about that. Otherwise there is one on here called CBT4PANIC but it is chargeable now, although it doesn't cost much. There is a free one called Panic Center too run by a Canadian company. Panic Center also have a support forum for those using it and there seem to be dome good people on there, one especially I can vouch for.

I don't know about St. John's Wort other than when you can't use it with various meds. There are people on here who know a bit more and some threads on the Natural Remedies board though. It would be worth a look or a thread. There may be other natural remedies you can also try which help some people but it does mean trying various things until you find if something works. There are certainly some interesting ones with studies though. I know a good supplements website that is a bit like a Wiki and lists all the studies and how relevant they are to what they were trying to treat with the substance.

I really hope you can get some help in the next few days and feel a bit more settled. I think they need to look at your care plan again and try to tide you over until your CBT can commence, whether that is now or later with longer support in between.

[Goldenbuddha001]

Hi Terry,
Much appreciated for your thorough response at this critical moment in time.

My anxiety has become so extreme (which has just been confirmed by the Nurse here that it's likely to be rebound anxiety from stopping the Diazepam which is what I suspected) So in my scheduled follow up appointment with the crisis team on Wednesday I requested to be voluntarily admitted. I felt I could no longer cope & felt too consumed by self harm/pure O complusions & being messed about with the CBT was most likely the final straw after literally feeling like I was hanging on by a thread!

I have been so proactive but the nature of the problem dictates & shouldn't fall upon myself to do everything like I have been.
The mental health worker consulted with my psychiatrist being deeply concerned he reluctantly admitted me for a crisis stay with the intention of it being only for a few days.

In regards to Diazepam I was on it on & off through the course of last year in between trying different medications. I did have a couple of months break around Oct-Nov & started taking them again in December especially over the Christmas period.
In all honesty I didn't ever take valium for more than three weeks, they say you can quickly build up a dependency around the 3-4 week mark. I do believe I should of perhaps tapered off it more sensibly this time round. After a week of taking it whilst I was away I basically just stopped it when I came back thinking it was only a relatively short time. It was pretty much my fault even though the doctors should have been monitoring the situation. Like you say they don't appear to be very clued up on withdrawal & the after affects of taking benzodiazepines. They seem to be under the impression that with taking it in low doses that I won't really experience withdrawal symptoms. In the end I felt it was no longer benefiting me from taking it anyway.

I see my psychiatrist tomorrow morning when he conducts his ward round. I have just been making some notes expressing points & concerns to put to him so I don't forget whilst I am in the appointment.

I feel I should wait to consult with him in regards to CBT rather than ringing them again. He may himself be able to put a bit of pressure on the psychology department & like you say hurry them along.
I was told by two separate entities that the CBT would commence this month but was palmed off with the excuse that there is a new therapist starting & that there has been numerous referrals Christmas/start of new year which has no relevance to my situation not my concern considering I should be top of that list. I appreciate that there are others in desperate need of help. She couldn't tell me as to when I will be seen but to ring at the end of the month. If my psychiatrist can't hurry them along then I certainly will outline the situation.

I am torn as far as my medication is concerned. My psychiatrist maintains there are still some left to try but having tried so many I am left wondering will I ever find something suitable to balance my anxiety levels herbal or pharmaceutic. I have tried 9-10 different medications excluding the valium. I will take up your suggestion of enquiring further on this forum with herbal alternatives because it's like a minefield & I don't know where to begin as most take some time to take effect. I feel in the present moment I need some instant relief & also help with sleeping but worried about being dependant on an anti anxiety med. It's a double edged sword.

My Mum had a pretty bad fall this morning which shook her up. Luckily nothing is broken but she hurt her knees. Right away from being informed my mind was producing awful thoughts & I could hear laughter in my mind which I feel guilty over. I also felt disingenuous with my texts of concern.
I think what I find most difficult is the emphasis on my mother as previously mentioned. Even though the harm ocd has pretty much latched on to practically everyone the obession with my mother stands out most.
My mind pretty much goes into overdrive.
She along with my father visited me last night in the hospital & the moment I saw her I saw how emotionally concerned she was in her eyes & the thoughts materialised again leaving me feeling bad for the remainder of my time with them.
Her expressing emotion towards me conjures up an uneasy sense of self. Although it's touching to know she cares it is quickly replaced with my obsessing over those emotional displays & how I feel about them, then that harm ocd comes into play. The magnitude of these feelings leads me to obsess over the future. I keep questioning whether I am feeling genuine guilt or not.
I keep getting the images & thoughts of me slashing her throat & hear myself apologising whilst performing the act, & also explaining to my Dad that I am sorry but I have to kill your wife. Even writing this makes me feel ill at ease.

My psychiatrist diagnosed me as having BPD with obsessive traits which as ridiculous as it may sound makes me sometimes question whether I actually have the full disorder of OCD even though it has been confirmed by two psychotherapists. Maybe he didn't want to overwhelm me by attaching another label. It seems common for BPD & OCD to be running along side each other. It does worry me because there is another condition running in the background that it would be the catalyst for me ever acting out the urges & complusions.
Jeffrey Dahmer was an individual who was diagnosed as having BPD & struggled to contain his urges. I fear this could be me.
The uncertainty is still something I struggle to live with. I am still trying to accept the bpd diagnosis, I feel there is some hurt & a bit of anger which is exacerbated by the ocd towards my parents for my diagnosis. I had a bit of a turbulent time with them growing up to early adulthood. Even though our relationship has vastly improved over the past few years in my late twenties particularly I can't help but feel a bit of anger that I have this illness. I am not sorely holding them responsible but they undoubtedly play a part in my emotional instability as I didn't have the necessary consistent emptional support at privitol moments but yet they are here now which I know is important even if they don't fully understand.

I am trying to focus on being here & using the time constructively by keeping busy & trying to get as much rest as possible.


It feels surreal being here & I can't help but wonder if I'm going to be in & out these places for years to come as part of the recovery process.

Golden.

[MyNameIsTerry]

Hi Golden,

Rebound is tough. However, perhaps having a cause means you have something more to work on? You know what is driving the current escalation and rebound can be beaten and you can be more yourself and able to push forward again? Perhaps it just alters the short term goals?

It's funny you should say about them not thinking withdrawal wold be felt on low doses because I've seen several of the members on here say they found it much easier coming down in large chunks from the high doses but those last low doses were the hardest for them. I've only used Diazepam a little when starting meds so it's never been an issue for me but after a week on them once I stopped feeling the benefit so didn't bother with them and initially this is where I moved onto my first SSRI. When I eventually came off that SSRI, because I was doing well, I found the hardest part of the withdrawal was dropping from 50-0% and the previous step was easier. Both weren't too bad anyway but I was in a good place at that point.

Those excuses are just garbage to me. They new a new therapist was starting before and I don't see why a new therapist, on top of the one you were booked to start with, has any bearing on the service levels expected of them. That therapist will have been trained & had to qualify through hours of supervision. At this point it will be up to a supervisor to get her settled. Why should the patients suffer? These therapists have to experience therapy over so many hours to qualify and that should allow them to just start when they walk through the door. They have their supervisors there anyway and if they need induction, they can sit in on other therapists sessions, they don't need babysitting as they have already done it to qualify.

I think sometimes the NHS give out excuses to just smooth things over and hope the patient doesn't ask questions as we are supposed to "trust our doctors" but that's an old attitude and things are changing so that we question what are essential services we have paid for in some way. I think you are doing the right thing anyway by using other people to achieve this, you have enough to deal with right now and don't need more pressure. Make them work for their money. It will come better from them since they can't use the excuses they can with the public.

Something that you need to consider is all the proactive work you have been doing. Many people in positions like yours don't do all that, they are too stuck, too obsessed with the thoughts. That shows you have a lot of strength and are very determined to beat this. This forum, and many others, have plenty of people who are going around in circles without making steps forward and they end up spiralling. Whilst you have this current painful setback, you still have that drive & determination and this is extremely important in recovery.

I understand your worries about whether there is something else in play. I think I must hear this one on every OCD thread about Pure O whether it's POCD, harm based, schizophrenia based, etc. And these are all people who only have OCD, not the additional challenges you have with BPD. I think you need to take some comfort from that, that others say exactly what you do and that those of us on here who have been through it & understand it, tell them we have been there too and come out the other side. We all thought there was a new personality coming out, the person we feared, but we have come through the other side and look back to see that it was just how our anxious minds work. We were more worried about the people around us and what it would do to them than we often were about the consequences for us, although some have that feature in their thoughts too yet I think the main issue is always the fear of the harm itself.

You have 2 medical professionals saying OCD and one sitting a bit on the fence and "hinting" at OCD traits. Anyone can have OCD traits. They don't diagnose OCD unless it is affecting your life. There many people on here who don't have OCD who have intrusive thoughts, but then all human's have intrusive thoughts. Intrusive thoughts are OCD spectrum but many of those people don't have it to the degree that a diagnosis is required. But even having an element, a trait, can mean it escalates under stress and feels more intense.

You could put it to him again and ask if this is only a trait or enough to be diagnosed. He probably just sees it as secondary to the BPD as opposed to needing a comorbid diagnosis. To him, that might mean it is every bit as strong as it is to the OCD diagnosed sufferer but perhaps he seems the BPD as being a primary and more important diagnosis? I don't know how they work. If they were both anxiety disorders they might just make a comorbid diagnosis, and the same with depression (if it presents at the same strength of the depression) but with a PD, I'm less sure as they are usually seen as more complex disorders needing more treatment to recover from from what I've read in the past.

I really really don't think you should be comparing your worries to people like Dahmer. How many people are there in world with a PD and how many of them are like Dahmer? This could just be you looking towards the worst, those Cognitive Distortions skewing your thinking.

Think of it this way, how many times have you seen someone with schizophrenia on TV? How many of those people have been violent and psychotic? How many were pretty normal and just struggling asking for help with their condition? I bet you the latter are a rarity. Why? Because the media needs the extremes to sell papers, to up the ratings on their channels, etc. Yet if you actually read about schizophrenia the medical professionals state violence is rare, even in the paranoid category where it most likely to occur, and the types of violent events we read or hear about are due to the complications of drugs. I remember reading that but ever time I see this condition on TV they are multiple murderers or sociopaths of some variety and only one occasion have I seen an actual medical documentary where I saw a poor guy struggling with it who just wanted help and was terrified of passing it on to his daughter. Since then again all I have seen are murderers, yet all science behind this says they are rare. If you think about it, of course they are rare because we always hear about them in the media and it's not very often. This is confirmation of how rare they are on top of what the professionals say.

So, apply that to the Dahmer argument. I've used that one with people on here with Pure O centred around Schizophrenia. Apply the acceptance you have been learning. Accept that these thoughts are natural concerns but they are to be let go.

I'm sorry to hear about your mother's fall but glad she is ok.

With this form of OCD an event like your mother's fall is bound to be latched onto. I'm not surprised you mentioned that internal laughing, I've had that too. Amusement at a loved ones misfortune. Then you focus on why you felt that and off it starts again. This is where learning not to feed it will help you free yourself from it. By observing the thought and just letting it go as nothing doesn't mean you don't care about your mum and it doesn't mean you don't think the thoughts were wrong, it's just a strategy to bring them back inline by starving them of the negative reaction they want to reinforce themselves. I know it's all confusing.

What you mentioned about whether you were feeling guilt is something I've come across before, in myself and with others on here. What I believe is that you cannot truly feel guilt for what you haven't done, you can only feel guilt about the thought. So, trying understand whether the guilt you are feeling is enough for that act you have committed is just not going to work because it can't. I think this is where you have to remember how thinking about doing something is very different to looking back after crossing a line and feeling guilt over an action.

For instance, thinking about having sex with another man than your BF isn't cheating. Some people think it is and kick themselves over it, and obviously ROCD sufferers do as it's part of their obsession. But if you actually do it, isn't that a totally different thing? Wouldn't the level of guilt you feel be far stronger? Wouldn't the intensity and varying emotions differ substantially to the mere thought of doing it?

That's how I see Pure O when it comes to an emotion that is meant to be based on something that has occurred. You can't truly feel it until you are there.

I worry about my parents as they are mid seventies. I worry about the grief I would feel and what that could do to my anxiety issues. BUT how on earth can I experience that grief until I actually go through it?

How about another example? We are always saying how you can't truly know how bad anxiety & depression (and your BPD) feel until you go through them. So, how can we expect to look forward on an event and expect to truly know how we should feel then? We haven't been through it. I can easily say that I can't truly feel how bad I felt when I was really bad with my anxiety. I just can't imagine it anymore but that's really how it should be or else I could easily be tipped back into it. I remember how I was but I can only feel so far, I can't reach how that feeling felt from that suffering anymore.

This is why it's important to rationalise. Does that make sense?

[Goldenbuddha001]

Hi Terry,

I am going to be discharged from my ward on Thursday. If I hadn't of felt so desperate I wouldn't of come in to hospital. The lack of care especially one-one & curt attitudes have been appalling. Pretty eye opening stuff. I thought my last hospital stay was bad in parts but this was shocking. The only saving grace I guess is seeing my psychiatrist well before the next outpatient appointment which is on the 19th & being monitored whilst starting new drugs. I am glad of that in case there may be an adverse reaction despite it being low doses.


I was placed on Abilify 5mg & promethazine 2mg (to help with sleep) last week.

The Abilify in the first few days seemed to provide some initial relief, my anxiety has returned but isn't as prominent. I am hoping as time passes that it provides further benefit. I was slightly reluctant at first given the fact that it is an antipsychotic & most haven't agreed with me. I haven't had any negative side effects so far other than a bit of nausea which I am sure will pass once my body has adapted to the change. An increase could happen at some stage, all depends on how I cope on the outside.
My psychiatrist is going to try & hurry things along with the CBT. I will have my last ward round on Thursday & will be discharged. I am a little nervous about going it will be the first time I will be alone with my mum & given how I have been feeling some anxiety is still present but this isn't the right place for me, that much is apparent. I fortunately have been able to get some rest in my room & catch up on some much needed sleep. That has been extremely frustrating. I was reaching the exhausted stage. Also, the home care treatment team will be in touch within seven days to monitor how I am, so that is also good. So overall the stay hasn't been completely unproductive.

I just hope that I will manage to get back into a routine again once I am home & be able to cope ok.

Golden,

[Goldenbuddha001]

*Update*

I am home now. Was discharged on Thursday. My anxiety is high given that I am out, some of it is to be expected. The obsession around my Mum in particular is insufferable. My psychiatrist is going to do his utmost to find out when my CBT starts next week before my appointment with him a week today. Fortunately I had a full nights sleep last night.

I was tempted to compile a complaint in regards to my time in there but I know how they can work, they have the power to make things very difficult for you if you find yourself in a position in the future requiring further treatment. It's a shambles.

[MyNameIsTerry]

Hi Golden,

It seems like luck of the draw with these services. Some people on here have said they have been excellent and others have given the more old fashioned impression of them being far from peaceful places.

I'm glad you managed to get some sleep. It surprising how much lack of sleep can affect us. For many of us it seems to strip our defences and the anxiety runs rampant. Lack of sleep was what pushed me over the edge in my relapse.

It's going to be a worrying time like you say, any adjustment can be. It's the change and uncertainty again but getting back into your routine should help with this.

I think your mum will need to be mindful of the impact her presence has until you can move forward a bit with the CBT. You've got your dad too and the impact of his presence was less so perhaps there is some room to manoeuvre there until you can feel more comfortable around her? I'm sure they will be very worried but if you need your space, they need to listen to that.

I think you are right about the ward, they are not the right place for a lot of people, it's really just a matter of some security at the worst time when you are unsure of how you can cope on your own. At the time you felt you needed that and now you have pushed past it and want to do things your own way again.

I would have thought if anything that this would only add to the case for the CBT. So, hopefully that gets sorted soon.

If the med helps, that's all that matters right now. You can deal with reducing it to a maintenance level of cut it out completely later when you are more settled. Perhaps having that to hold you from dipping too far is worth it right now until you get some support and move forwards to a point when it becomes less important to you.

Take care. I hope you continue to have some good quality sleep and settle back into your home quickly.

[Goldenbuddha001]

Hi Terry,

I just had my appointment with the CMHT it went ok but felt I was holding back. When I have seen them before they don't usually know much about OCD.

I am also scared of revealing to my Mum that she is the main theme of my thoughts, urges, etc. I am scared of judgement, don't want to upset her (them) , I feel ashamed etc.

When I have revealed to my Dad about it previously he was hesitant even though that's probably a normal involuntary human reaction I can't help but think that maybe he may be worried or there's a possibility he may be worried in the future.

I am also worried that because of the thoughts & urges that I won't be able to resist acting them out, my mind tells me my future looks bleak. Even though I test myself be acting out the scene in my mind I find myself shouting out loud 'NO!"

Thank you for your kind words, I do hope I manage to settle a bit since returning.
Golden,

[MyNameIsTerry]

Hi Golden,

That's a bit worrying that they don't know about OCD, it's so common these days. I get how the Pure O side is more unknown but some of the OCD subtypes are so common and are stereotypes so they should at least understand the cycles.

I can understand that about your mum. I never told mine, or anyone, I managed to find my way out of them but my other forms were far more intense so were the harder ones to crack. I get the shame element, OCD makes you feel like you are not in control of your own mind and body, how can people understand that?

I think it's likely anyone being told about the Pure O ones is going to be very much in the dark. They may think about more serious mental health issues because they are the ones they here about e.g. POCD. How on earth would anyone know about POCD, but they know about paedophiles...so it's an obvious thing to think of when someone describes their POCD. Harm based is the same, isn't it? They may think about violent people because that's all we hear about through the media or in fiction.

I think the way forward with that is to give them information. Let them see that it's real. Show them the charity websites explaining it, let them talk to your medical professionals who will reassure them it's only OCD and not something more sinister. If they can see a great big wall of information showing them it's possible, and you have the backing of those professionals, then they can't deny it exists and will have to spend some time processing it all to learn to accept it.

Unless your dad knows about these forms of OCD, his natural reaction is bound to be worry - for you both. Look what we are shown on TV. Every time there is a storyline in a programme about mental health and violent thoughts, it's someone who ends up doing them or various horrible acts to people. Once you learn the truth, you can change your thinking, just as we did.

Look at schizophrenia, which I've probably mentioned in here already. Whenever we see it, it's violence and usually disturbing crimes. Go on to medical/charity websites and they say it's rare and the result of drug misuse. If I was diagnosed with Paranoid Schizophrenia, what would my parents think? They would know about all the things they have seen on TV and it would worry them. Then they sit in front a doctor who tells them that's all media sensationalism and gives them the real facts and the they are reassured because they have been given official medical guidance that they can trust. They may still have their worries here & there, it's natural, but they won't be thinking back to the sensationalism.

You won't act on them, they affect you this badly and that's the sign they are the opposite of your character. It's rare for someone with OCD to act on their compulsions in this manner. Otherwise wouldn't the prisons & hospitals be full of us?

It is true that your reaction will change as you go through recovery. Your "No" may become a silent "whatever", "who cares", and some people then worry this is a sign of changing but it's not, it's a sign of desensitising to the fear element and this starves the subconscious of that tick in the box to keep the process valid. This is just part of the way out.

All the best.

[Goldenbuddha001]

Hi Terry,
It's been exceedingly difficult since coming out of hospital. I have had a few moments of crisis particularly last night. I found myself in A&E after a lapse in self harm again.

After attempting to point out to the crisis team several times within 24 hours that I felt suicidal & desperate I was told "We're fully booked up, no one can see you" "Wait till tomorrow" I was also told I was no longer eligible to access the crisis service as I am under secondary care & they're primary care.
My psychiatrist was on duty last night & made it clear that he didn't want me to be admitted again feeling it would have a detrimental affect on me with anxiety/depression levels. He also said for me to contact the local organisation that could help me with aftercare, transpires that they can't as I am acutely ill & state I should still be under the CMHT after being discharged from them just over a month ago & to be fast tracked onto their services again. My recovery has evidently been affected by all of this.

The new medication is making me feel very poorly too so this is another thing to emphasise to my psychiatrist tomorrow that these antipsychotics are definitely not for me. I feel manic & very unstable despite it being low in dose, I felt bad prior to bring admitted but this is too much.

I just feel abandoned at the moment & hanging on by a thread. The impulses are extremely strong. I am sat here really feeling the struggle of being alone with my Mum.
I just hope my appointment goes ok tomorrow & something is put in place.

Golden,

[MyNameIsTerry]

Hi Golden,

I'm really sorry to hear this. How are you feeling now?

It really does annoy me how these professionals can't see that their behaviour adds to the pressure on people. When you are like this, you don't need bureaucratic red tape, you just need someone to take over and get things moving. I can't see why one service can't call another and take the pressure off. We used to do this all the time in my trade in the private sector and that was just utilities. We didn't just say "sorry madam, that's another team so ring this number...(well the crap employee jobsworths would)...we called them up and arranged a callback fairly quickly. I dislike this passing people from list to another and sitting them at the back of the queue just because red tape means they were in the wrong one. In a mental health crisis service and a 2nd line people dealing with more serious concerns this is simple disgraceful.

I just don't understand why they can't see the impact of their behaviour on people? Who is holding them to account? I've seen plenty of cases where people have harmed themselves or gone missing just because of things like this and nothing ever seems to change.

I'm not surprised you feel abandoned, who wouldn't. They are bouncing you between services.

Have you seen Carolin's thread on the depression board? When she started having issues with her CPN (and service) I mentioned your thread because you had explained about their woeful attention to your previous complaint. She has similar issues with no one phoning back from crisis teams, turning up to an appointment to find her CPN is off sick and she hasn't been notified. Basic stuff.

Perhaps your psychiatrist may have a better option with a different antipsychotic? You know what it's like with meds, it's so often experimental. Perhaps there is still a chance he may find you a good fit? If you are ending up in A&E after self harm episodes, it's clear this med isn't doing enough and they need to have a plan on what comes next. I hope they have something that can help you.

I can imagine with all this the intrusive thoughts are worse. They always get worse with increased anxiety levels. I don't think there is much that can be done naturally with that right now if the med is causing a spike so hopefully removing the med or switching will decrease this so you can get back to where the thoughts were before. With meds spiking anxiety you know it's a matter of toughing it out until you come through the other side.

Hang in there.